Estimated glomerular filtration rate (eGFR) is a prime measurement to determine whether kidney disease patients can tolerate contrast agents. For example, patients with an eGFR less than 30 mL/min/1.73 m2 risk severe reactions to contrast agents, including the debilitating condition nephrogenic systemic fibrosis (NSF).
For their study, researchers from the Medical University of Warsaw imaged 34 patients in various stages of chronic kidney disease and 20 healthy volunteers on a 1.5-tesla MRI scanner (Ingenia, Philips Healthcare). The imaging protocol included two DWI sequences, and the group collected apparent diffusion coefficient (ADC) values, eGFR results, and creatinine blood levels from certain regions of interest to correlate and compare results.
Lead author Dr. Katarzyna Sułkowska and colleagues found a significant positive correlation between ADC and eGFR, along with a negative correlation between ADC and creatinine blood level. Cutoff values were established based on ADC measurements that allowed identification of patients with eGFR higher than 60 mL/min/1.73 m2 and lower than 30mL/min/1.73 m2.
"DWI-MRI could be a noninvasive tool for monitoring progression of chronic kidney disease, as changes in diffusion correlate with renal function," Sułkowska told AuntMinnie.com. "Also, measurements of diffusion parameters could help in decision-making on contrast administration in patients with unknown glomerular filtration rate."
Sułkowska and colleagues plan to investigate changes in diffusion parameters in patients after renal transplantation to determine if DWI could be helpful in assessing and prognosing graft function.
